Monthly Archives: March 2009

Something I wrote in my mini-blog, the Broken Ankle Log there on the side, got me to thinking. I think it deserves its own post. Here’s what I wrote over there:

Two days ago I met an older gentleman student who lost his foot in the service some 30 years ago. When he saw me approaching on my crutches he smiled kindly and asked what had happened. My fellow students have generally been nice and offered to help me if I need something, but it was a bit more ‘comforting’ to talk to someone who’d also experienced being unable to walk (he now walks with a prosthetic). It made me think that there need to be more characters with disabilities on TV shows. It seems like we mostly see disabled people on TV as “inspiration” stories, stuff that kinda says “this teenager who lost his legs is out there surfing, so what excuse to you ‘able-bodied’ people have for sitting around on your asses?!”

So I was trying to think of characters and TV personalities with physical disabilities, or other things that put them outside the mainstream. I thought of the kid from Malcolm in the Middle who was in a wheelchair, Joe Swanson on Family Guy, Edward Elric from Fullmetal Alchemist, and of course, Dr. Gregory House. There was the show Blind Justice on ABC, but that got canceled pretty quickly. I also thought of Josh Blue, who won the fourth season of Last Comic Standing. On Detroit’s local Fox 2 news, there’s Lee Thomas, who did a report where he took off the makeup that hides his vitiligo. But are there enough people with disabilities or who are otherwise outside the mainstream on television? I don’t think so. According to the U.S. Department of Health and Human Services’ Office on Disability, “the prevalence of disability in the U.S. population has been measured fairly consistently at 18-19 percent.” [Source] Granted, they’re talking about all forms of disability combined, but either way, I think it’s a fair amount of the population that deserves to be represented regularly in pop culture, especially television shows and movies.

Why is this important? For the same reason that it was important to rewrite school textbooks so that they reflect the fact that girls and women also exist, instead of always writing math story problems and examples with “he” as the only pronoun, or referring to all humans as “mankind.” For the same reason that it’s important to have racial diversity on television, and body size diversity. Pop culture is such a huge part of our lives in this country. We spend so much time immersed in it, that we need to see ourselves reflected in that world. Otherwise, we might ask ourselves, “why do I not see people like me out there? Do I not exist elsewhere? Is there something I don’t know?” Here in the US we say we value individuality, but in truth, for any human being, complete, true uniqueness is frightening. It’s why all of our fictional heroes with superpowers yearn to be “normal.”

I recall an interview with Whoopi Goldberg where she said that it had been so amazing for her to see Nichelle Nichols as Lt. Uhura on Star Trek, how it was wonderful to see a black woman on TV that wasn’t a maid. (I think this interview was on the extra features of one of the DVDs for Star Trek: The Next Generation.) Interestingly, a friend of mine dismissed Lt. Uhura, saying she was nothing but an intergalactic secretary. Perhaps it’s hard for people my age to understand the impact Nichols had all the way back in 1966, but I’m sure many young black girls back then were happy to see a black woman on TV who, as Goldberg said, wasn’t a maid, or in a disparaging role. The main reason I started watching the now-gone soap opera Passions was because I was flipping channels, saw a white woman making an effort to say the name “Luis” correctly, and thought, “what the hell?! Hispanic people on daytime American television? I’ve got to see what this is about!”

Even now, TV shows are much more diverse racially than they used to be, but it’s generally a segregated diversity; that is, there are shows for whites, blacks, to a lesser extent, Latinos, and I can’t think of a single show with a Native American, Asian, or mid-eastern cast (at least not in the US. There is Little Mosque on the Prairie on the CBC, but in the US, unless you live close to Canada you probably haven’t seen it). On many shows, the person who is of a race different from that of the main cast is usually the lovable idiot character, such as the white firefighter on Tyler Perry’s House of Payne or the Asian girl on Hannah Montana. These characters are so unimportant I can’t even remember their names (though I haven’t seen too much of Hannah Montana). Though I most definitely think that these small acknowledgements that not all people are white are better than nothing.

I’m not advocating that all shows become “melting pots.” A while ago Larry Gabriel wrote a column in the Metro Times about how sometimes he just doesn’t want to be the black guy that’s “integrating” a joint. I personally feel better in Mexicantown, where I live, than I do in Detroit’s suburbs, and it’s not because I’m afraid of running into a white supremacist who’ll beat me up. It’s because I know that in Mexicantown, if I want something specific to Hispanic culture, I can probably get it. It’s nice to know that I’m surrounded by people who know what semitas and platano frito are. It’s silly, but a wee part of me is disappointed when a good friend says they don’t like Mexican food. (I’m not Mexican, but with one exception it’s the closest thing around here.) I want them to enjoy what I enjoy. That’s generally why people become friends. Symbolically though, sharing food is on another level. Likewise, I understand the positive impact it has on people to see that a show’s main cast reflects them, and thus can reflect their life experiences. I just think it would be better to work diversity in, in a way that feels natural like on Scrubs, rather than having token diversity. There, I said it.

So, we see that racial diversity on TV is important. So is diversity of ability. (Which reminds me, in Detroit there’s a group called Diverse Ability.) As it’s natural to seek comfort when going through any hardship by finding others who are suffering the same, it was comforting to make the joke that I am now like Dr. House: with a bum leg and hopped up on vicodin, to have that cultural reference. Or to call myself Fullmetal Ankle. Or meeting that gentleman who smiled kindly, with understanding. For me, the disability is temporary, but for many others, it is not, making it even more important to have reflections of real life’s people with disabilities on television. Plus, it would also help people without disabilities to stop the reaction we sometimes have upon seeing someone in a wheelchair or using a white cane: pity. For the most part, people don’t enjoy being considered pitiable.

I’m writing this mostly to offer some food for thought, as I think it unlikely that a television exec with the power to make changes or a screenwriter is gonna land on this blog. But you never know. Gotta put positive stuff out there to the Universe. ^_^

Ack! Update: After I published this post, I noticed something: all of the TV characters and personalities I thought of who have disabilities are men! I can’t think of any female characters with disabilities. Yuffie from Final Fantasy VII wore what looked like a leg brace, but there’s no evidence in the game that it was anything other than a costume design choice. I can only think of movies about real-life women who had disabilities, such as Helen Keller or Frida Kahlo. What’s up with this?

Really?! Update: So the first comment I got for this was spam from an adult video company saying that their mission is to represent diverse people to serve all clients’ needs. And the thing is…I think porn probably is more diverse than TV shows. @_@;; Whatever your fetish is, they have a video for you! Of course, this one good thing does not compensate for an industry that includes images of women being brutalized in its repertoire. It’s just kind of ironic to me.

More adventures in medical billing: it turns out that even though the latest anesthesiologist’s bill I received says “payment due upon receipt,” and says that their credit policy is “Bills are due and payable when rendered,” you actually can call and set up an installment plan. While I’m much relieved, it does leave a bad taste in my mouth that they don’t write that on the bill. To their credit, Detroit Receiving Hospital does put all the payment options there on the bill, so when you get it you don’t freak out completely like I did when I got the anesthesiologist’s.

I called the hospital to see if I could at least get a list of who to expect bills from. I was told to call Billing, which was wrong, because they only do the billing for the Hospital, not the doctors. But the billing woman told me I would have to request my medical records to see all the doctors that have worked on me. She gave me the number for one of the doctors’ billing agencies, but that number turned out to be disconnected. When I go to the clinic next week I’ll try and see what I can find out about getting my records.

I am, at the moment, the most at ease I’ve been since the accident, because I got some very good news. At the hospital, I was told I might qualify for uncompensated care, since I was in that situation of having too much to qualify for Medicaid but not enough to pay for surgery. In the course of trying to get answers about who exactly was billing me, I was told that the hospital did indeed cover my surgery itself. I am so thankful to Detroit Receiving Hospital. I don’t usually feel comfortable saying stuff like this out loud, but Thank God and St. Therese! And of course, the DRH. I have been crying so much for these past weeks, thinking I was bringing about my family’s ruin, after my mother worked so hard to get us out of poverty. But I’m still worried, because I still don’t know how many doctors’ and anesthesiologists’ bills I’m going to get, not only from the surgery, but from visits to the clinic, and I may need physical therapy. If one anesthesiologist costs $1300, how much will the surgeon?

This week’s cover story on the Metro Times was “The Young and Uninsured.” One of the key points in the article is that the jobs young people get these days don’t come with benefits, so a quarter of the uninsured are people aged 19 – 29. It was interesting to read the stories of the young people they highlighted. I kinda did a self-pity laugh when one of them said he stopped biking because it was dangerous. Though now I feel a bit guilty because, if I understood it correctly, the article says that when hospitals have to give uncompensated care to people who can’t pay, it drives the premiums and co-pays of the insured up. If that’s the case, we might as well pay more in taxes so that everyone has coverage. Why can’t we have a health care system that’s about taking care of people, rather than making a profit (and an obscene one at that)? Making profits on products and services that are not essential to life is okay, but things like education and health care should not be about profits. Insurance companies that don’t want to pay out when their customers need the coverage they have been paying for are especially undeserving.

I really want to know why medical billing is set up the way it is. Why is it that the services of doctors, anesthesiologists, and the hospital facility itself are billed separately?

This isn’t the post I was writing today. As I was writing the other post, my brother handed me a bill. I thought about not opening it, because I know what happens when I do: I get depressed and can’t think about anything else for hours. My thoughts go:

“How am I going to pay this?”

“Will my family survive this financial hit?”

And then when I get really cynical:

“This is what I get for following my heart and studying art instead of one of the big money careers like medicine or mortuary science. They need to stop telling people that ‘follow your dreams’ bullshit. Money doesn’t buy happiness, but poverty doesn’t buy shit!”

Before I had surgery, I was told the price of fixing my broken ankle was $20,000. I was told I could get on a payment plan and pay the balance off in three years. I was devastated, but I thought, okay, it’ll be three years of sacrifice, we’ll make it. But that was before I knew that the hospital bill was separate from the doctor’s bill. Now I’m wondering, does that estimate include all the different kinds of bills, or was that just the hospital bill? Because if it’s the latter, I am thoroughly fucked. It’s difficult to get my questions answered, because the bills are coming from separate agencies, and the people answering the phone don’t know their own agency’s rules sometimes, much less each others’. Case in point: the woman who called me from the hospital to say that the surgery would cost about 20K said I’d have to make a down payment. The day of the surgery, a woman came to me to sign a form for the payment plan, but then no one came to collect the down payment. I asked another lady that came by about the down payment and she said, “You mean your insurance info? Someone will come for it” and left. Before I was discharged from the hospital, my mother asked a nurse about this, and he said “Down payment? That’s crazy! Who told you that? You’ll just get a bill.” I later asked some of the staff at the hospital’s orthopedic clinic about this, and they likewise thought the down payment business was very strange.

Another example: when I called the hospital to set up the payment plan for the ER bill, and asked about that business with separate bills for the doctor and hospital, the guy told me that I would have to set up payment plans for the doctor’s bills separately. But the doctor’s bills (technically, the anesthesiologists’) I’ve been getting say nothing about the option of paying in installments, and the one I got today says “payment due upon receipt.” Damn!

And yet another: when I went to make a payment in person at the hospital’s Cashier, the clerk took a long time. When she got back to me, she told me my accounts had been combined and to use a new account number. So I asked, is the installment still $500? Because I set up a payment plan for one account, not several, so will the monthly payment change? She said something like, “I don’t think so, she didn’t say anything about how much to pay, just told me to take your payment.” And I ask, “Who is ‘she’?” The clerk then clarifies for me that she had had to call her boss. So basically, the clerk taking payments doesn’t know the ins and outs of the hospital’s billing system! And it’s not like my case is unique: I’m sure there are other people that went to the ER, needed follow-up care, and had to have their accounts combined. Considering we’re dealing with tens of thousands of dollars, I should think the staff taking patients’ money would be more thoroughly trained.

Okay, so they bill everything and everyone separately. Would it be so hard for the hospital to send an itemized summary of everything, so that patients know what to expect? Because right now, I know bills are coming, but I don’t know how many, I don’t know when, I don’t know for how much, and I don’t know if they’ll let me pay in installments. I even wonder if some slick anesthesiologist who didn’t even work on me is billing me. After all, how would I know, I was unconscious! I was expecting bills from one female and one male anesthesiologist, the ones that spoke to me. But I’ve gotten bills from 2 male anesthetists. WTF? At the time they knocked me out, there were about 6 people in the OR. I knew that wasn’t everyone but, when the doctors went to see me afterward, they came in and said, “This is the orthopedic team that worked on you” and there were like 15 of them! How did that team even fit in that tiny OR?! And if they were rotating, why? The procedure only took 2 and a half hours. If they were rotating to let residents get some experience, why do I have to pay for 5 people to learn on my dime rather than pay just one?

Then I start thinking, I should have tried to get some independent insurance. But then I remember how my aunt had to fight her husband’s insurance company when he had a bad accident and they didn’t want to pay. I think about the fact that the most basic COBRA plan my mother was considering for me was $500 a month, so had she been paying for it since the time her employer’s insurance dropped me it would have been $12,000, but then it probably wouldn’t have covered this surgery, because it was basic coverage!

Insurance itself is fraud. At least the way it’s set up right now.

But unfortunately, things don’t change until lots and lots of people are either screwed over or get killed. I’ll admit, I’ve always been critical of the insurance companies, but I didn’t try to do anything about it. How many of us saw Michael Moore’s Sicko, said “For shame!”, then went on our merry way?

I’ve been trying to draft a letter for my Congress people, but where to even start? I’m not sure universal health care is the answer, if that system gets set up like one big insurance company. Then it’ll be the same shady, inefficient, bureaucratic mess, where no one knows what the hell’s going on, but ultimately the people that want your money will get it because that’s all that matters.

Would it really be so hard to say to a patient: “One hour with one doctor costs $X. One hour in the OR costs $X. One hour with one anesthetist costs $X. So X doctors, One OR, and X anesthesiologists makes for a grand total of $XX. Barring any complications, that is your grand total, and you can pay in installments.” No mystery. Because right now these bills are like the threat of an assailant in a dark alley: I know they might be there, but how many of them will there be, and will they strike? And if these doctor’s bills were NOT a part of that initial $20,000 estimate, how fraudulent to say that one can get on a payment plan, when all these separate bills are due immediately! Or even if they don’t want to give a cost summary, how about at least a list of people to expect bills from? It’s not like they don’t know who worked on me that day. And if they don’t know, then hell, that’s even worse! I assume that all the doctors, anesthetists, and whoever else immediately log how long they did what to whom. The first anesthetist’s bill I got had the procedure start and end time on it.

If any medical professionals stumble on this blog, please share your knowledge with me. Or anyone who’s been through or going through this, share your experiences. This uncertainty is by far the most stressful part of this injury, because my family’s finances, and therefore future, are in the balance. It’s more stressful than lying on the sidewalk trying to get passersby to help, worse than not being able to walk, worse than seeing my ankle sutured up like Frankenstein, swollen and bruised. And it shouldn’t be that way.

I’ve been living a lie! Douglas Adams was not the first person to be obsessed with towels. Turns out Tokugawa era (1600-1867) Japanese really knew where their towels were at.

Check out this passage from Susan Hanley’s book on material culture, Everyday Things in Premodern Japan (p. 71-2):

The Japanese also invented a very useful, resource-efficient type of towel, known as the tenugi. … Since the tenugi was just a rectangular piece of cloth, it could be used for everything from a head covering or headband to a towel or a protective cover to keep dirt and flies off food. Used wet, it served as a washcloth, and when wrung out, it could be used to dry the body, particularly after a hot bath. It was small enough to tuck in practically anywhere, and thin enough to dry very quickly in the damp Japanese climate. … The tenugi was so popular that it was given as a gift on festive occasions. Though the Western bandana was used in multiple ways, its use was limited by comparison to the tenugi.

Doesn’t that sound like the part in Hitchhiker’s Guide to the Galaxy where Ford Prefect explains the importance of having a towel to Arthur? How different would their adventures have been if they’d had tenugi instead of bulky, terry cloth towels? A question fit for Deep Thought indeed.